mental-health

Original source / Raw SKILL.md

---
name: mental-health
description: Mental health tracking - psychological assessments (PHQ-9, GAD-7), mood diary, therapy progress, and crisis management planning
argument-hint: <operation_type+info, e.g.: assess phq9, mood anxious 7, therapy session 24, crisis plan create>
allowed-tools: Read, Write
schema: mental-health/schema.json
---

# Mental Health Management Skill

Mental health assessment and tracking, including standardized scales, mood diary, therapy records, and crisis management.

## Core Flow

```
User Input -> Identify Operation Type -> Extract Parameter Info -> Check Completeness -> [Need Supplement] Ask User
                                                      |
                                                   [Information Complete]
                                                      |
                                              Generate JSON -> Save Data -> Output Confirmation
```

## Step 1: Parse User Input

### Operation Type Recognition

| Input Keywords | Operation Type | Description |
|----------------|----------------|-------------|
| assess, assessment | psychological_assessment | Psychological assessment |
| phq9, phq-9 | phq9_assessment | PHQ-9 depression screening |
| gad7, gad-7 | gad7_assessment | GAD-7 anxiety screening |
| psqi | psqi_assessment | PSQI sleep quality assessment |
| gds | gds_assessment | GDS geriatric depression screening |
| epds | epds_assessment | EPDS postpartum depression screening |
| mood | mood_diary | Mood diary |
| trigger | mood_trigger | Trigger factors |
| coping | coping_strategy | Coping strategies |
| diary | mood_diary_view | View mood diary |
| pattern | pattern_analysis | Mood pattern analysis |
| therapy | therapy_record | Therapy record |
| crisis | crisis_management | Crisis management |
| progress | therapy_progress | Therapy progress |
| goals | therapy_goals | Therapy goals |

### Mood Type Keywords

| Input Keywords | Mood Value |
|----------------|------------|
| happy | happy |
| calm | calm |
| anxious | anxious |
| sad | sad |
| angry | angry |
| tired | tired |
| frustrated | frustrated |
| excited | excited |
| depressed | depressed |
| irritable | irritable |
| nervous | nervous |

### Mood Intensity
- Numbers 1-10

### Trigger Factor Keywords

| Input Keywords | Trigger Factor |
|----------------|----------------|
| work | work_deadline, work_pressure |
| sleep | lack_of_sleep |
| pain | chronic_pain |
| relationship | relationship_issue |
| family | family_conflict |
| money, financial | financial_stress |
| crowd | crowd |
| weather | weather |

### Coping Strategy Keywords

| Input Keywords | Coping Strategy |
|----------------|-----------------|
| deep_breathing | deep_breathing |
| meditation | meditation |
| exercise | exercise |
| walk | walk |
| journaling | journaling |
| socializing | socializing |
| music | music |
| reading | reading |

### Effectiveness Keywords

| Input Keywords | Effect |
|----------------|--------|
| very_helpful | very_helpful |
| helpful | helpful |
| somewhat_helpful | somewhat_helpful |
| not_helpful | not_helpful |

### Therapy Type Keywords

| Input Keywords | Therapy Type |
|----------------|--------------|
| cbt | CBT |
| psychodynamic | psychodynamic |
| humanistic | humanistic |
| family | family |
| group | group |
| dbt | DBT |
| emdr | EMDR |

### Crisis Warning Signs

| Input Keywords | Signal |
|----------------|--------|
| hopelessness | hopelessness |
| withdrawal | social_withdrawal |
| mood_swings | extreme_mood_swings |
| death | talk_of_death |
| self_harm | self_harm |
| suicidal | suicidal_thoughts |

### Risk Level

| Input Keywords | Risk |
|----------------|------|
| low | low |
| medium | medium |
| high | high |

## Step 2: Check Information Completeness

### Mood Diary Required:
- Mood type
- Mood intensity (1-10)

### Psychological Assessment Required:
- Assessment type
- Total score

### Therapy Record Required:
- Session number
- Session date

### Crisis Plan Required:
- Plan type (create/update/view)

## Step 3: Interactive Prompts (If Needed)

### Scenario A: Missing Mood Intensity
```
How intense is this mood?
Rate on a scale of 1-10 (1 being mildest, 10 being most intense)
```

### Scenario B: PHQ-9 Assessment
```
Please answer the following questions (In the past 2 weeks, how often have you been bothered by the following problems?)

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself - or that you are a failure
7. Trouble concentrating on things
8. Moving or speaking slowly, or being fidgety/restless
9. Thoughts that you would be better off dead or of hurting yourself

Each question scoring: 0=Not at all, 1=Several days, 2=More than half the days, 3=Nearly every day
```

### Scenario C: Crisis Risk Assessment
```
If you have any of the following, please seek professional help immediately:

1. Having thoughts or plans of self-harm or suicide
   - Call psychological crisis hotline: 400-xxx-xxxx
   - Go to the nearest psychiatric emergency
   - Call emergency number: 120

2. Hallucinations, delusions
3. Completely out of control emotions
4. Severely impaired functioning

What is your current situation?
```

## Step 4: Generate JSON

### Mood Diary
```json
{
  "id": "mood_20250620083000001",
  "date": "2025-06-20",
  "time": "08:30",
  "mood": "anxious",
  "intensity": 7,
  "triggers": ["work_deadline"],
  "coping_strategies": ["deep_breathing"],
  "effectiveness": "somewhat_helpful",
  "notes": "Work pressure causing anxiety"
}
```

### PHQ-9 Assessment
```json
{
  "assessment_date": "2025-06-20",
  "scale": "phq9",
  "total_score": 8,
  "max_score": 27,
  "severity": "Mild depression",
  "items": [0, 1, 1, 2, 1, 0, 1, 1, 1],
  "recommendation": "Observe for two weeks, seek medical help if no improvement"
}
```

### GAD-7 Assessment
```json
{
  "assessment_date": "2025-06-20",
  "scale": "gad7",
  "total_score": 12,
  "max_score": 21,
  "severity": "Moderate anxiety",
  "items": [2, 2, 2, 1, 2, 2, 1],
  "recommendation": "Recommend medical consultation, consider psychotherapy"
}
```

### Therapy Record
```json
{
  "session_number": 24,
  "date": "2025-06-20",
  "duration_minutes": 50,
  "therapy_type": "CBT",
  "topics_discussed": ["anxiety", "work_stress"],
  "mood_before": "anxious",
  "mood_after": "calmer",
  "homework_assigned": "thought_record"
}
```

### Crisis Plan
```json
{
  "created_date": "2025-06-20",
  "warning_signs": ["hopelessness", "social_withdrawal"],
  "emergency_contacts": [
    {"type": "spouse", "phone": "***-****-1234", "availability": "24/7"}
  ],
  "coping_strategies": ["deep_breathing", "grounding_technique"],
  "current_risk_level": "low"
}
```

Complete schema definition: see [schema.json](schema.json).

## Step 5: Save Data

1. Read `data/mental-health-tracker.json`
2. Update corresponding sections based on operation type
3. Update statistics
4. Write back to file

## Execution Instructions

```
1. Identify operation type
2. Extract parameter information
3. Check required field completeness
4. If missing, ask user to supplement
5. Generate JSON compliant with schema.json
6. Save to data/mental-health-tracker.json
7. Output confirmation and recommendations
```

## Example Interactions

### Example 1: Record Mood
```
User: mood anxious 7 work stress

AI: Mood diary recorded
Time: 2025-06-20 08:30
Mood: Anxious
Intensity: 7/10 (High intensity)
Triggers: Work stress

Recommendation: Try deep breathing or meditation to relieve anxiety
```

### Example 2: PHQ-9 Assessment
```
User: assess phq9 score 8

AI: PHQ-9 assessment result recorded
Total score: 8/27
Severity: Mild depression

Assessment: Mild depressive symptoms
Recommendations:
- Increase exercise
- Improve sleep
- Reduce stress
- Observe for two weeks, seek medical help if no improvement

Note: If item 9 (self-harm thoughts) score >= 1, recommend medical consultation
```

### Example 3: Therapy Record
```
User: therapy session 24 cbt anxiety work_stress

AI: Therapy session recorded
Session number: 24
Therapy type: Cognitive Behavioral Therapy (CBT)
Topics discussed: Anxiety, Work stress

Next therapy reminder: Please record this week's thought diary
```

### Example 4: Crisis Plan
```
User: crisis plan create

AI: Let's build your crisis intervention plan together

1. Warning Sign Identification
   What signals indicate you might need help?
   - Feelings of hopelessness
   - Social withdrawal
   - Extreme mood swings

2. Emergency Contacts
   Please add reachable family or friends or therapist

3. Coping Strategies
   What methods help when warning signs appear?

4. Professional Resources
   - Psychological crisis hotline: 400-xxx-xxxx (24 hours)
   - Psychiatric emergency: Nearest Grade-A tertiary hospital
   - Emergency number: 120

Crisis plan created. You can update with:
- /crisis sign add [warning sign]
- /crisis contact add [contact] [phone]
- /crisis strategy add [coping strategy]
```

For more examples, see [examples.md](examples.md).

## Medical Safety Boundaries

### Cannot Do:
- Make psychological diagnoses (mental illness diagnosis must be done by a psychiatrist)
- Prescribe psychiatric medications
- Predict suicide risk or self-harm behavior
- Replace professional psychotherapy
- Handle acute psychiatric crises
- Provide specific psychotherapy plans

### Can Do:
- Mental health screening and assessment (using standardized scales)
- Mood pattern identification and trend tracking
- Crisis warning sign reminders
- Coping strategy recommendations (non-therapeutic)
- Therapy progress recording and tracking
- Emergency resource information provision

### Emergency Situation Handling:
If any of the following, seek professional help immediately:
1. Thoughts or plans of self-harm or suicide
2. Hallucinations, delusions
3. Completely out of control emotions
4. Severely impaired functioning

Emergency resources:
- National psychological crisis hotline: 400-xxx-xxxx (24 hours)
- Psychiatric emergency: Nearest Grade-A tertiary hospital psychiatry department
- Emergency number: 120


---

## Referenced Files

> The following files are referenced in this skill and included for context.

### schema.json

```json
{
  "$schema": "http://json-schema.org/draft-07/schema#",
  "$id": "https://wellallyhealth.com/schemas/mental-health-tracker.json",
  "title": "MentalHealthTracker",
  "description": "心理健康管理数据结构定义",
  "type": "object",
  "properties": {
    "psychological_assessments": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "assessment_date": {"type": "string", "format": "date"},
          "scale": {
            "type": "string",
            "enum": ["phq9", "gad7", "psqi", "gds", "epds"]
          },
          "total_score": {"type": "integer"},
          "max_score": {"type": "integer"},
          "severity": {"type": "string"},
          "items": {
            "type": "array",
            "items": {"type": "integer"}
          },
          "recommendation": {"type": "string"}
        },
        "required": ["assessment_date", "scale", "total_score"]
      }
    },
    "mood_diary": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "id": {"type": "string"},
          "date": {"type": "string", "format": "date"},
          "time": {"type": "string", "pattern": "^([0-1]?[0-9]|2[0-3]):[0-5][0-9]$"},
          "mood": {
            "type": "string",
            "enum": ["happy", "calm", "anxious", "sad", "angry", "tired", "frustrated", "excited", "depressed", "irritable", "nervous"]
          },
          "intensity": {"type": "integer", "minimum": 1, "maximum": 10},
          "triggers": {
            "type": "array",
            "items": {"type": "string"}
          },
          "coping_strategies": {
            "type": "array",
            "items": {"type": "string"}
          },
          "effectiveness": {
            "type": "string",
            "enum": ["very_helpful", "helpful", "somewhat_helpful", "not_helpful"]
          },
          "notes": {"type": "string"},
          "created_at": {"type": "string", "format": "date-time"}
        },
        "required": ["id", "date", "mood", "intensity"]
      }
    },
    "therapy_records": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "session_number": {"type": "integer", "minimum": 1},
          "date": {"type": "string", "format": "date"},
          "duration_minutes": {"type": "integer", "minimum": 15, "maximum": 120},
          "therapy_type": {
            "type": "string",
            "enum": ["CBT", "psychodynamic", "humanistic", "family", "group", "DBT", "EMDR", "other"]
          },
          "topics_discussed": {
            "type": "array",
            "items": {"type": "string"}
          },
          "mood_before": {
            "type": "string",
            "enum": ["happy", "calm", "anxious", "sad", "angry", "tired", "depressed", "irritable"]
          },
          "mood_after": {
            "type": "string",
            "enum": ["happy", "calm", "anxious", "sad", "angry", "tired", "depressed", "irritable", "calmer"]
          },
          "homework_assigned": {"type": "string"},
          "homework_completed": {
            "type": "string",
            "enum": ["completed", "partial", "not_completed"]
          },
          "notes": {"type": "string"}
        },
        "required": ["session_number", "date"]
      }
    },
    "crisis_plan": {
      "type": "object",
      "properties": {
        "created_date": {"type": "string", "format": "date"},
        "updated_date": {"type": "string", "format": "date"},
        "warning_signs": {
          "type": "array",
          "items": {
            "type": "string",
            "enum": ["hopelessness", "social_withdrawal", "extreme_mood_swings", "talk_of_death", "giving_away_possessions", "self_harm", "suicidal_thoughts", "substance_abuse"]
          }
        },
        "emergency_contacts": {
          "type": "array",
          "items": {
            "type": "object",
            "properties": {
              "type": {
                "type": "string",
                "enum": ["spouse", "parent", "friend", "therapist", "colleague", "other"]
              },
              "name": {"type": "string"},
              "phone": {"type": "string"},
              "availability": {
                "type": "string",
                "enum": ["24/7", "evening", "weekend", "work_hours"]
              }
            },
            "required": ["type", "phone"]
          }
        },
        "coping_strategies": {
          "type": "array",
          "items": {
            "type": "string",
            "enum": ["deep_breathing", "grounding_technique", "progressive_muscle_relaxation", "mindfulness", "call_friend", "safe_space", "sensory_grounding"]
          }
        },
        "current_risk_level": {
          "type": "string",
          "enum": ["low", "medium", "high"]
        },
        "professional_resources": {
          "type": "array",
          "items": {
            "type": "object",
            "properties": {
              "name": {"type": "string"},
              "type": {"type": "string"},
              "contact": {"type": "string"}
            }
          }
        }
      }
    },
    "therapy_goals": {
      "type": "array",
      "items": {
        "type": "object",
        "properties": {
          "goal_id": {"type": "string"},
          "description": {"type": "string"},
          "category": {
            "type": "string",
            "enum": ["symptom_reduction", "coping_skills", "behavior_change", "relationship", "self_esteem", "other"]
          },
          "baseline": {"type": "integer", "minimum": 0, "maximum": 10},
          "current": {"type": "integer", "minimum": 0, "maximum": 10},
          "target": {"type": "integer", "minimum": 0, "maximum": 10},
          "target_date": {"type": "string", "format": "date"},
          "status": {
            "type": "string",
            "enum": ["pending", "in_progress", "on_track", "behind", "achieved", "cancelled"]
          }
        },
        "required": ["goal_id", "description"]
      }
    },
    "statistics": {
      "type": "object",
      "properties": {
        "last_phq9_score": {"type": "integer"},
        "last_gad7_score": {"type": "integer"},
        "mood_trend_7days": {
          "type": "string",
          "enum": ["improving", "stable", "declining"]
        },
        "therapy_sessions_count": {"type": "integer"},
        "most_common_mood": {"type": "string"},
        "avg_mood_intensity": {"type": "number"}
      }
    },
    "metadata": {
      "type": "object",
      "properties": {
        "created_at": {"type": "string", "format": "date-time"},
        "updated_at": {"type": "string", "format": "date-time"}
      }
    }
  }
}

```

### examples.md

```markdown
# mental-health 技能示例

## 一、PHQ-9 抑郁筛查

### 示例 1: PHQ-9 评分记录
```
用户: assess phq9 score 8

AI: 已记录PHQ-9评估结果
总分: 8/27
严重程度: 轻度抑郁

评估: 轻度抑郁症状
建议:
- 增加运动
- 改善睡眠
- 减少压力
- 观察两周，如无改善考虑就医
```

### 示例 2: PHQ-9 详细记录
```
用户: assess phq9 items 0,1,1,2,1,0,1,1,1

AI: 已记录PHQ-9评估结果
总分: 8/27

各题得分:
1. 做事时提不起劲: 0
2. 感到心情低落: 1
3. 入睡困难: 1
4. 感觉疲倦: 2
5. 食欲不振: 1
6. 觉得自己很糟: 0
7. 对事物专注困难: 1
8. 动作/说话改变: 1
9. 自伤念头: 1

严重程度: 轻度抑郁

注意: 第9项得分>=1，建议关注情绪变化
```

### 示例 3: 查看PHQ-9历史
```
用户: phq9 history

AI: PHQ-9评估历史趋势
━━━━━━━━━━━━━━━━━━━━━━━━━━
2025-01-15: 12分 (中度抑郁)
2025-02-15: 10分 (轻度抑郁)
2025-03-15: 8分 (轻度抑郁)
2025-04-15: 6分 (轻度抑郁)

趋势: 改善中，继续监测
```

## 二、GAD-7 焦虑筛查

### 示例 4: GAD-7 评分记录
```
用户: assess gad7 score 12

AI: 已记录GAD-7评估结果
总分: 12/21
严重程度: 中度焦虑

评估: 中度焦虑症状
建议:
- 学习放松技巧
- 规律运动
- 减少咖啡因
- 建议就医咨询
```

### 示例 5: GAD-7 带描述
```
用户: assess gad7 score 6 轻度焦虑，工作压力大

AI: 已记录GAD-7评估结果
总分: 6/21
严重程度: 轻度焦虑
备注: 工作压力大

建议: 学习焦虑管理技巧，观察两周
```

## 三、情绪日记

### 示例 6: 记录情绪
```
用户: mood anxious 7 work_deadline

AI: 已记录情绪日记
时间: 2025-06-20 08:30
情绪: 焦虑
强度: 7/10
触发因素: 工作截止日期

建议: 可以尝试深呼吸或冥想来缓解焦虑
```

### 示例 7: 记录应对方式
```
用户: mood anxious 7 work_deadline coping deep_breathing helpful

AI: 已记录情绪日记
时间: 2025-06-20 08:30
情绪: 焦虑
强度: 7/10
触发因素: 工作截止日期
应对方式: 深呼吸
效果: 有帮助

建议: 继续使用有效的应对方式
```

### 示例 8: 查看情绪模式
```
用户: pattern

AI: 情绪模式分析（近7天）
━━━━━━━━━━━━━━━━━━━━━━━━━━
最常见情绪: 焦虑
平均强度: 6/10

主要触发因素:
- 工作压力 (4次)
- 睡眠不足 (3次)

最有效的应对方式:
- 深呼吸 (80%有帮助)
- 散步 (75%有帮助)

趋势: 情绪波动较大，建议关注睡眠和工作压力
```

## 四、治疗记录

### 示例 9: 记录治疗会话
```
用户: therapy session 24 50minutes cbt anxiety work_stress

AI: 已记录治疗会话
会话编号: 24
时长: 50分钟
治疗类型: 认知行为治疗 (CBT)
讨论主题: 焦虑, 工作压力

下次治疗: 请记录本周的思维日记
```

### 示例 10: 查看治疗进展
```
用户: therapy progress

AI: 治疗进展报告
━━━━━━━━━━━━━━━━━━━━━━━━━━
治疗次数: 24次
治疗时长: 约3个月

PHQ-9变化:
- 开始: 15分 (中重度)
- 当前: 8分 (轻度)

GAD-7变化:
- 开始: 14分 (中度)
- 当前: 10分 (中度)

治疗目标:
- 情绪管理: 进行中
- 认知重构: 进行中
- 行为激活: 已达成

评价: 治疗进展良好，继续坚持
```

## 五、危机管理

### 示例 11: 创建危机计划
```
用户: crisis plan create

AI: 让我们一起建立您的危机干预计划

1. 预警信号识别
   哪些信号表明您可能需要帮助？

2. 紧急联系人
   请添加可联系的亲友或治疗师

3. 应对策略
   当出现预警信号时，什么方法有帮助？

4. 专业资源
   - 心理危机热线：400-xxx-xxxx（24小时）
   - 精神科急诊：就近三甲医院
   - 急救电话：120

已创建危机计划，您可以用以下命令更新：
- /crisis sign add [预警信号]
- /crisis contact add [联系人] [电话]
- /crisis strategy add [应对策略]
```

### 示例 12: 添加预警信号
```
用户: crisis sign add hopelessness

AI: 已添加危机预警信号
信号: 绝望感

当前预警信号:
- 绝望感
- 社会退缩

这些信号出现时请启动您的危机应对计划
```

### 示例 13: 添加紧急联系人
```
用户: crisis contact add spouse ***-****-1234 24/7

AI: 已添加紧急联系人
类型: 配偶
电话: ***-****-1234
可用时间: 24/7

当前紧急联系人: 1人
```

### 示例 14: 更新风险级别
```
用户: crisis risk low

AI: 已更新当前风险级别
风险等级: 低风险

建议: 定期监测，保持健康生活方式
```

## 六、查看所有评估

### 示例 15: 查看评估摘要
```
用户: assessments

AI: 心理评估摘要
━━━━━━━━━━━━━━━━━━━━━━━━━━
最近评估:

PHQ-9 (抑郁):
- 最近: 8分 (轻度) - 2025-06-20
- 趋势: 改善中

GAD-7 (焦虑):
- 最近: 10分 (中度) - 2025-06-20
- 趋势: 稳定

PSQI (睡眠):
- 最近: 9分 (睡眠差) - 2025-06-15
- 趋势: 需关注

建议: 焦虑和睡眠需要关注，考虑与治疗师讨论
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